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JL Ageing > Week 1 part 1 > Flashcards

Week 1 part 1 Flashcards

1
Q

Give three factors in human ageing?

A
  1. Random molecular damage during cell replication
  2. Inactivity, poor diet, inflammation increase damage
  3. Reduction in body’s adaptive reserve capacity
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2
Q

What is the end part of each chromosome arm?

A

Telomere

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3
Q

What happens when each telomere progressively shortens with each cell replication?

A

Senescence

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4
Q

What can telomerase do?

A

Re-extend shortened telomeres - active in some cells like immune cells, stem cells

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5
Q

What 4 main cellular responses does damage cause?

A
  1. Repair
  2. Apoptosis
  3. Senescence
  4. Malignant transformation
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6
Q

What term is given to loss of homeostasis and resilience and increased vulnerability to decompensation after a stressor event?

A

Frailty

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7
Q

What is sarcopenia?

A

Age related loss of muscle mass and function

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8
Q

What are the three criteria for sarcopenia?

A
  1. Low muscle mass
  2. Low muscle strength
  3. Low physical performance
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9
Q

What is sarcopenic obesity?

A

Loss muscle mass with increased fat

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10
Q

What can cause increased risk of cardiometabolic disorders such as insulin resistance, metabolic syndrome or cardiovascular disease?

A

Sarcopenic obesity

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11
Q

How do you treat sarcopenia?

A

Exercise

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12
Q

In palliative care what is the smoothest delivery of medicines?

A

Syringe driver

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13
Q

At end of life what do you prescribe for pain/SOB?

A

Morphine

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14
Q

At end of life what do you prescribe for distress?

A

Midazolam

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15
Q

At end of life what do you prescribe for nausea/agitation?

A

Levomepromazinr

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16
Q

At end of life what do you prescribe for respiratory secretions?

A

Buscopan

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17
Q

Rapidly developing clinical symptoms and/or signs of focal, and at times global, loss of brain function, with symptoms lasting more than 24 hours or leading to death with no apparent cause other than that of vascular origin ?

A

Stroke

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18
Q

What type of stroke is cardioembolic?

A

Fibrin dependent “red thrombus”

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19
Q

What type of stroke is platelet dependent “white thrombus” (cf acute coronary syndrome)?

A

Atheroembolic

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20
Q

What area of the brain controls personality, emotional response and social behaviour?

A

Frontal lobe

21
Q

What area of brain is affected when disinhibition, lack of initiative, antisocial behaviour, iompaired memory, incontinence, grasp reflexes and anosmia

A

Frontal love

22
Q

What area of the brain controls calculation, language, planned movement and appreciation of size, texture and weight?

A

Parietal lobe dominant side

23
Q

What area of brain is affected when dyscalculia, dysphasia, dyslexia, apraxia, agnosia?

A

Parietal lobe dominant side

24
Q

What area of brain controls spatial orientation, constructional skills?

A

Parietal love non domionant side

25
Q

What area of brain is affected when neglect of non dominant side, spatial disorienttin, constructional apraxia, dressing apraxia and homonymous hemianopia?

A

Parietal lobe non dominant side

26
Q

What area of the brain controls auditory perception. speech, language, verbal memory, smell?

A

Dominant side temporal lobe

27
Q

When investigation a stroke - how would you identify an infarct or haemorrhage?

A

CT scan, MRI scan

28
Q

How do you investigate the aetiology of a stroke?

A

Carotid scan, angiogram, ECG, echo

29
Q

How do you manage an acute stroke?

A
  1. Thrombolysis
  2. Imaging
  3. Swallow assessment
  4. Antiplatelets
  5. Stroke unit care
30
Q

What is the only proven treatment for acute ischaemic stroke?

A

IV tissue plasminogen activator - dissolves clot (limited less than 4.5 hours from onset)

31
Q

Name some secondary prevention methods for stroke?

A
  1. Anticoagulants if cardioembolic/af
  2. Antiplatelets if not cardioembolic (first line clopidogrel)
  3. Stop smoking
  4. Statins
    5 Manage BP
32
Q

What is disturbance in attention, change in cognition and develops over a short period while fluctuating?

A

Delerium

33
Q

What is different between the onset of dementia and delerium?

A

Slow for dementia. sudden for delerium

34
Q

What four things diagnose delerium?

A
  1. Acute and fluctuating
  2. Inattention
  3. Altered level of consciousness
  4. Disorganised thinking
35
Q

Give three factors of hyperactive delerium?

A

Agitated, aggressive, wandering

36
Q

What is first line medication for delerium?

A

Haloperidol - excpet parkinsons

37
Q

What medication is given for patients with delerium and parkinsons?

A

Quetiapine

38
Q

When should you use benzodiazepines for delerium?

A

When alcohol withdrawl

39
Q

High stepping gait

Rombergs positive

A

Cervical myelopathy

40
Q

Altered sensation

Gait wide based

A

Peripheral neuropathy

41
Q

Pain/paraesthesia legs

Gait wide-based

A

Lumbar stenosis

42
Q

Gait wide based

Cerebellar signs

A

Cerebella ataxia

43
Q

Parkinson’s disease

A

Shuffling gait

Tremor, rigidity, bradykinesia

44
Q

Loss of executive function

Impaired risk awareness

A

Dementia

45
Q

What test can be done for falls?

A

Romberg test

46
Q

What environment do acidic drugs require for absoirption?

A

acidic e.g. phenytoin, aspirin and penicillins

47
Q

What environment do basic drugs require for absorption?

A

Diazepam, morphine, pethidine

48
Q

Do elderly have decreased hepatic metabolism?

A

Yes due to decreased size, blood flow and disease

49
Q

What medication doses are effective in elderly?

A

Low

JL Ageing (2 decks)

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